Abstract
A 20-year-old Warmblood broodmare was presented to the primary
veterinarian for bilateral nasal discharge, which had been treated with
sulfamethoxazole without complete resolution. The mare was referred to
Cornell’s Equine Hospital after she began dropping feed without losing
weight. Oral exam, radiography, computed tomography (CT) of the head,
and upper airway endoscopy were performed, revealing a left sided nasal
abscess filled with feed material due to an associated oronasal fistula
between the left maxillary premolars (207 and 209) with reactive bone
extending past 210. The abscess was debrided, and drainage was
established via a transnasal standing approach under endoscopic
guidance, with conservative management of the affected teeth. Repeated
follow-up evaluations included upper respiratory endoscopic and oral
endoscopic exams to monitor abscess resolution and to evaluate the
compromised periodontal attachment of the affected teeth. This case
highlights 1) the importance of advanced imaging in cases of equine
nasal and sinus disease and 2) the success of conservative dental
management when faced with a case of severe periodontitis with
subsequent oronasal fistulation.